Socioecomic position and health. Is it relevant to MS? #MSBlog #MSResearch
is uncontroversial that socio-economic position (SEP) directly and
indirectly effects quality of health and more and more quality of health
provision. Class inequalities characterize over four fifths of
officially recorded causes of death. There are pivotal and fundamental
symptoms of relative poverty, which determine an array of environmental
and biological factors that in turn increase rates of mortality,
morbidity and generally poor health.
was shown in a 1958 study of British Males that birth weight
corresponds to Housing inadequacy and financial difficulties. Indeed
biology seems to determine SEP as well as SEP determining biology. A
child’s height at the age of 7 has been shown to directly correlate to
their chances of unemployment.
So how does the NHS effect this matrix of determinant factors?
can deduce two levels at which a national health system attempts to
ameliorate the situations of a population’s lower classes.
The first level
is that of education, which is essentially a preventative measure. In
reality this involves working against the default positioning of
individuals facing an adverse SEP. With more quotidian
and fundamental priorities education becomes seemingly remote from
their day to day needs. However, a health system will try and educate on
matters such as nutrition and lifestyle. It has to be said that the NHS
has played a significant role in making smoking socially unacceptable
and advocating legislation preventing smoking in public places. So
within preventative measures there is legislation about education,
literally barring unhealthy habits and there is also the dissemination
of information, which aims at raising awareness of key issues.
The second level
at which a health system will try to improve the health of individuals
facing adverse socio-economic positioning is the tailoring of the system
to accommodate for the tendencies of those effected by their social
class. Types of interaction from professionals working in the system
will be designed in order to welcome individuals and encourage them to
seek medical help. For instance - SEP is shown to correspond to the
chances of domestic violence, also linked to alcohol and drug abuse,
which is tied into SEP – work done to encourage women to seek help in
the community when they are subjected to violence from their husband or
are, however, ways in which health systems undermine themselves and
accentuate class divisions in the operative places of health provision.
in the NHS, a recent development and a product of the Health and Social
Care Act (2012) not only creates a materially two tiered health system.
It also re-enforces class in the hospital. By having medicines withheld
for less well off patients they are implicitly but unmistakenly told
that you are as good as your money. Further, the deeply entrenched class
divisions of English Society are not simply about money. Class
consciousness can manifest itself through deep insecurities about moral
fibre and character. This undoubtedly has bearings on one’s health as
stress and anxiety takes a physical toll.
Many regard the notions of tough, well-versed
middle class patients dominating the health system and rendering it two
tiered as a myth.
I do not think that they are a mythical people, and indeed represent the class divisions I am speaking of.
the problem is not localised incidents of class consciousness, where
staff are more respondent to middle class patients, the real problem is
more far reaching and generalised. There is a dramatic inequity between
NHS services in the inner city and the countryside or suburb (click here).
This highlights a typical capitalist contradiction where the stated
aims of a State Service are subverted by powerful class interest
ultimately working to undo the State of which they (class interest) are
the deepest stakeholders.
Labels: health inequality, politics